Choice of Therapeutic and Diagnostic Measures for Acute Diverticulitis of the Color Intestinal With Development of Local Inflammatory Complications

Abstract

Summary: Introduction. Diverticular disease of the large intestine accounts for 30-60 % of all organ pathologies, among which acute diverticulitis is 20-60 %.
 The aim of the study was to select therapeutic and diagnostic measures for acute diverticulitis of the large intestine with the development of local inflammatory complications.
 Materials and methods. The results of treatment of 68 patients with acute diverticulitis were analyzed. Diagnostics included clinical and laboratory studies, irrigography, colonoscopy, ultrasound, computed tomography.
 Research results. 61.8 % of patients with Ia, Ib stages of acute diverticulitis were treated conservatively. Drainage was installed under ultrasound control into the abscess area in 10.3 % of patients with acute diverticulitis in stage Ib. Laparoscopic intervention was performed in 22.1 % of patients. Operated on emergency indications 33.8 % of patients with II, III, IV stages of acute diverticulitis from laparotomic access. Postoperative mortality was 8.7 % of cases.
 Conclusions:1. Comprehensive assessment of clinical, radiological, endoscopic data, ultrasound, CT data allows to establish the clinical form and stage of acute colon diverticulitis and to choose the correct treatment tactics. 2. Multicomponent drug therapy is a rational method of treatment in patients with stage Ia, Ib acute diverticulitis. 3. Surgical treatment is indicated in acute diverticulitis complicated by perforation and peritonitis, profuse intestinal bleeding or intestinal obstruction caused by cicatricial stricture. 4. The proposed therapeutic and diagnostic algorithm for acute diverticulitis of the large intestine with the development of pyoinflammatory complications should be introduced into the practice of general surgical departments.